Constance takes issue with cancer co-payment costs

SueEllen Yates, left, Norma Parsons, Liz Rankin and Jennifer Mozina and the recent Cancer Council conference in Sydney.

SueEllen Yates, left, Norma Parsons, Liz Rankin and Jennifer Mozina and the recent Cancer Council conference in Sydney.

Member for Bega, Andrew Constance has denied that cancer patients are paying more than $150 per cycle of treatment but Cancer Council NSW says it has evidence to the contrary and Merimbula cancer survivor, SueEllen Yates said: I know there are people in this electorate who pay more than $150 per cycle.”

Mrs Yates said: "The concern we hold and have raised is that in some parts of NSW a patient will pay a co-payment for each chemo drug prescribed for their first round of treatment, and then a co-payment for any new chemo drug should their treatment be changed.  In some other parts of NSW the same patient would not be charged.  In other states this patient would not be charged.  We're calling on the government to fix this problem here in NSW."

Mr Constance was responding to concerns raised in the News Weekly by Mrs Yates and the NSW Cancer Council about the cost of chemotherapy treatment and associated drugs in NSW. 

Mr Constance said: "The information provided by Ms Yates was a deep concern to me and I have taken those concerns to my colleague and Minister for Health, Jillian Skinner seeking a brief on the claims surrounding co-payments and the PBS.

"All will agree that patients have enough emotional and physical anguish without the additional pressure of having to ensure their access to treatment is dependent on whether or not they can afford it," Mr Constance said.

However he said that according to information he had received from Mrs Skinner’s office, since 2013 NSW patients no longer pay $150-$400 drug costs per cycle.

“The changes made in 2013 have dramatically reduced the costs for cancer patients needing multiple treatment cycles,” Mr Constance said.

“I am further advised that since 2013, NSW outpatients pay a one-off PBS co-payment for each original prescription dispensed for chemotherapy medicines for injection/infusion, and no co-payment for repeat prescriptions. The co-payment cost for an original prescription is $6 for concessional or $29.50 for general patients,” Mr Constance said.

“The Australian Government set co-payment is charged to public out-patients in other jurisdictions, not just NSW or the ACT,” Mr Constance said.

But community pograms co-ordinator at the Cancer council NSW, Jennifer Mozina said: “There are many complexities around chemotherapy payment but there’s no question that patients are paying for their first round of treatment, and any changes thereafter, and this can create undue pressure. 

“It’s true that patients can be charged in other states, however other states have found a solution for their patients and that’s what we need in NSW.”

One of the major issues raised by the Cancer Council NSW has been that patients visiting some hospitals, generally, but not exclusively, larger city hospitals, do not pay for their treatment whereas patients at Bega, Cooma and Moruya hospitals do and costs can vary widely according to the number and types of drugs prescribed.

Asked about the discrepancy, a spokeswoman for the federal department of health, said: “To access any medicine through the Pharmaceutical Benefits Scheme (PBS) the medicines must be assessed through a community pharmacy, a private hospital or a public hospital in a jurisdiction that is a signatory to the Pharmaceutical Policy Reform Agreement. 

“New South Wales (NSW) does not participate in the Reforms.  Patients receiving care at public hospitals in NSW cannot access PBS funded medicines under these arrangements. Therefore, it is up to the public hospitals in NSW to determine how much to charge their patients.”

Local NSW Cancer Council representatives have a meeting scheduled with Mr Constance on September 4.

Ms Mozina said: “I look forward to discussing the issue further with Mr Constance when we meet up as I can give more recent examples of patients still paying for chemotherapy in excess of $150 in 2014. The changes made by NSW Health in 2013 have not fixed the problem. That is why it is one of the top five issues in Cancer Council NSW Vision for Change document.”

Cancer Council wants to hear from you

A spokeswoman for Mr Constance said that the Bega office wasn’t getting flooded with people complaining about the costs of their cancer treatment but Mrs Yates said often after people get over their illness they just want to put it behind them.

The issue of co-payments for chemotherapy treatment is not restricted to breast cancer patients, it affects anyone receiving chemotherapy in NSW or the ACT.

The Cancer Council wants to hear from cancer patients.

Contact community programs co-ordinator Jennifer Mozina at Cancer Council NSW, Bega office on 6492 1805 or email jenniferm@nswcc.org.au

Local cancer patients and their carers can also contact SueEllen Yates on 0457 794 939 or email inkpink99@gmail.com

What’s the problem

Cancer patients in some areas of NSW are paying a co-payment fee (script fee) for their drugs and others are not. It depends which hospital you visit for your treatment. SueEllen Yates paid at Bega but her sister-in-law in Sydney did not pay.

While the co-payment is $29.50 as an outpatient at a public hospital, cancer patients may require multiple drug prescriptions during a chemotherapy cycle, some of which will be administered to deal with the side effects. There may be up to six cycles of treatment.

Anyone undergoing chemotherapy is unlikely to be well enough to work which adds to the financial burden and the overall stress.

Ms Mozina said that some patients were charged the maximum co-payment of $36.90.

NSW chemotherapy patients have access to the PBS safety net, whereby the maximum annual pharmaceutical co-payments before no co-payments are paid by a concessional patient is $360 or $1,421.20 for general patients but the safety net covers drug costs only.

The changes in 2013, quoted by Mr Constance, whereby NSW outpatients pay a one-off PBS co-payment for each original prescription dispensed for chemotherapy medicines for injection/infusion, and no co-payment for repeat prescriptions does not cover chemotherapy taken orally.

The federal department of health introduced the same reforms to chemotherapy medicines for injection/infusion on April 1, 2012.

Why is it different in NSW?

“The ACT and NSW do not participate in the reforms. As such, hospitals in NSW and the  ACT are not eligible to receive chemotherapy medicines under the PBS. In practice,  however, some hospitals have developed alternative methods to access chemotherapy medicines under PBS arrangements. These practices, identified during bilateral discussions with stakeholders, include public hospitals classifying patients (public or private) as ‘privately referred non-admitted’ patients and public hospitals undertaking in-house chemotherapy compounding for private outpatients.” 

Extract from a federal department of health document.

See previous story Local cancer patients pay more

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